Discovering the Current Wound Management Practices of Rural Africans: Pilot Study

Background: Unrelenting heat, poor sanitation, lack of knowledge, and poverty contribute to disabling wound prevalence that often exceeds 20% in rural areas of tropical developing countries. Wounds in this environment are usually poorly managed at very high cost. Traditional health practitioners and village health workers, rather than health professionals, provide health care in most villages. Wound management education for these nonprofessional health providers should include only sustainable practices which prove to be safe and effective in tropical villages. However, usual practice data, needed for comparison studies, was absent from the published literature.

Methods: This study introduced an innovative data collection method to overcome cultural obstacles which have prevented researchers from obtaining meaningful quantitative data in this challenging setting. UTMB’s IRB approved the study. Seventy-five participants from 25 diverse villages in Ghana provided detailed descriptions of their current usual topical wound management methods by completing patient stories representing seven wound types typically found in this setting, without prompts.

Statistics: Responses were tabulated and categorized as congruent (or not) with modern topical wound management principles within three domains and six subcategories. Four research questions were addressed with descriptive statistics and ANOVA

Results: Wound management practices of nonprofessional providers were identified and described in detail for the first time. Most participants described moist treatments, such as bandages or occlusive herbal poultices, regardless of wound type. Safe wound cleansing and debridement were described less consistently.

Conclusions: These results, confirmed by smaller studies in rural areas of other tropical developing countries, provide the usual practice data needed to design a comparison study to help ensure the ecological validity (both safety and efficacy) of wound recommendations for villagers. This research is foundational to the process of developing culturally and environmentally appropriate wound management protocols for indigenous wound care providers in rural areas of tropical developing countries.